Bilateral flatfoot before Surgery and  Bilateral flatfoot after Surgery
Ankle Arthroscopy and Subtalar Arthroscopy
Ankle Arthritis in Rhuematoid patient and Ankle Replacement in Rhuematoid Arthritis
Diabetic foot before Surgery and Diabetic foot after Surgery
Claw toe deformity in Rhuematoid patient and Claw toe deformity in Rhuematoid patient after surgery
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Hallux Rigidus


Hallux Rigidus or Arthritis of Big Toe Joint (Big Toe Joint Stiffness)


Hallux Rigidus is a condition caused by arthritis of the base of the big toe. It commonly affects active people and can be as a result of repeated minor trauma or direct injury. The symptoms depend upon the severity of joint disease. They range from mild discomfort and stiffness on walking to pain at rest. A swollen toe or a swelling on the top of the big toe can also be noticed. Surgery should be undertaken if you have ongoing pain in the feet which affect your walking and day to day activities.Hallux Rigidus is often associated with Hallux Valgus or Bunion Deformity and is common in patients suffering from Rheumatoid Arthritis.
 
  xray picture showing moderate to severe arthritis of big toe joint   intra operative picture showing dorsal osteophytes  

Surgery can involve removing excess bony prominence (cheilectomy) or fusion of the big toe joint or a total big toe joint replacement. Surgery for Hallux Rigidus improves your pain, walking and ability to do most of the day to day activities significantly.

Surgery for Hallux Rigidus

Cheilectomy of Big Toe

This involves opening the joint by a small cut. Any excess arthritic bone (osteophyte) which forms on the top edge of the joint is removed. This should allow an increased range of upwards movement post-operatively. Any loose cartilage within the joint is also removed and any discreet areas lacking cartilage are drilled with fine wires.

  xray picture showing dorsal osteophyte   foot picture showing dorsal swelling  

 

  picture showing improvement in toe movement after surgery      

 

  picture showing removal of osteophytes in the above surgery   xray after surgery showing removal of dorsal osteophytes  

 

Details of surgery at the clinic

On the Day – Surgery can be done under General Anaesthetic with patient asleep or under local Anaesthetic Ankle Block. Surgery is done as a day case and patient has no pain after surgery due to nerve block.

The foot

This will be in a post-operative bandage.

The foot should be kept elevated as much as possible when resting for the first 48 hours. Try to avoid letting it hang down when sitting and elevate up on two pillows while sleeping at night.

 

  post surgery bandage

Mobility

You will be walking after surgery putting full weight through your foot but in a special shoe.

Length of stay in Hospital

You can go home same day after your operation.

At two weeks

The patient will require an outpatient review and wound check. The dressings will be removed and the patient may now get the foot wet. The patient will be instructed on exercises depending upon the type of operation. If it is a smaller operation like cheilectomy you are instructed to discard special shoe and start walking in your own shoes. For Fusion surgery this is continued or 6 weeks

How likely is it to work?

Surgery is a reliable treatment option. In well trained hands success rate is better than or equivalent to any other orthopaedic operation

Fusion Surgery

What is a big toe fusion, how does it work, and what can I do afterwards?.

The joint surfaces which generated pain are removed at the time of the fusion. The residual surfaces after removing arthritic bone are approximated together with metal screws or staples or plate. Over time bone grows across the surfaces leading to "bonding" or “Fusion”.

  xray picture before surgery   xray picture after fusion surgery  

Can I walk normally after Fusion of Big Toe Joint?

Fusion of Joint does not affect your normal walking. Compensatory movement and flexibility of inter-phalangeal joint help you in achieving this. Movements of big toe after surgery are shown in picture below.   

  normal walking aftre fusion surgery   toe range of motion after fusion surgery  

How long does it take to recover normal walking?

After the bone has fully united (6-12 weeks) there are no restrictions on activity.

Big toe replacement surgery?

Replacement of the big toe has a long though not yet satisfactory history. None of the previous implants have succeeded in being able to maintain movement, relieve pain long enough for us to recommend using them.

However on your request we have provision to perform one of the currently available Big Toe joint replacement operations for you.